I feel horrified. I feel like it’s 1980,” says Jose F. Colon, from the hospital bed in Puerto Rico where he is struggling to survive with AIDS amid an island-wide HIV-care emergency. With already scarce AIDS funds drying to a dribble, two large AIDS service organizations closed shop in early February, leaving 1,500 positive people without access to care. With more than 10,000 positive people, Puerto Rico’s HIV rate is comparable to that of the U.S. The AIDS rate, however, is double the mainland’s. One hundred and thirty people are currently on an unofficial waiting list for treatment, with many more in need of meds. Many AIDS clinics that remain open lack working bathrooms, telephones, air conditioning or adequate staff.

As a U.S. commonwealth territory, Puerto Rico received $58.4 million in Ryan White funding last year from the feds. But advocates say local officials are not getting the cash to those in need. The Puerto Rico Department of Health and the San Juan AIDS Task Force often stall up to nine months when clinics request reimbursements for expenses. “It has gotten critical in the last three years,” says Anselmo Fonseca, co-founder of Pacientes de SIDA Pro Politica Sana, a nonprofit AIDS advocacy group. “People’s lives are in danger, and too many key players either lack competence or … don’t give a damn.” This winter Fonseca and other AIDS activists in Puerto Rico and on the U.S. mainland wrote two letters to the U.S. Health Resources and Services Administration (HRSA) and one to Michael O. Leavitt, Secretary of the U.S. Department of Health and Human Services, requesting the feds intervene and put the funds in the hands of responsible local agencies that will actually get care to positive people.

They have reason to want help from off the island. Officials from the San Juan AIDS institute were convicted of embezzling over $2 million in AIDS funds in 1999 and 2000. Then in December 2006, the FBI and IRS raided the ASO’s offices, confiscating thousands of files and copying hard drives. No charges have been filed, but advocates fret that the missing files could cause an added delay in getting AIDS funds onto the street. Let’s hope the U.S. government does more than just write back.